I Lost My Brother to ADHD

I am an ADHD expert, and I was my twin brother's safety net. Was there anything I could have done to prevent his fatal car accident?

It is clear from many studies that irreparable harm can befall adults with ADHD when on the road. Just as clear is the fact that those with driving problems can be helped by medication.

~Russell Barkley, Ph.D.

My brother, Ron, had ADHD in his early childhood, and it continued all his life -- which ended abruptly, six years ago, when he was 56, in a single-car accident in Keene, New York. That accident can be attributed to his ADHD and its impact on his driving habits -- speeding, risk-taking, distractibility, use of alcohol, and disdain for the seatbelt.

Ron was out for a pleasure drive on a fine summer evening on a dirt road, enjoying the beautiful Adirondack Mountains, as he loved to do. He had just finished a 10-hour shift as a chef and had had a drink with our 92-year-old mother before grabbing some dinner and jumping into the used van he had bought and fixed up. We had spoken by phone a few days earlier. He was the happiest I had heard him in a while, because of his new job. After years of odd jobs and playing guitar and singing in rock bands, he was finally going to get some benefits.

It is clear from many studies -- some conducted by me -- that irreparable harm can befall adults with ADHD when on the road. Just as clear is the fact that those with driving problems can be helped by medication. So how could the brother of an ADHD expert not receive treatment?

How to Help Our Loved Ones

The predictors for automobile crashes in adults with ADHD are severity of symptoms, older age, the number of speeding tickets they receive, a poor credit rating, and high levels of hostility. All but the last were factors in my brother’s crash.

What are family members, and clinicians, to do about these risks? Studies show that stimulants can improve driving performance, so, obviously, we should strongly encourage medication whenever adults with ADHD get behind the wheel. That is easier said than done. You can talk about driving risks all you want, but it was my brother's -- and any adult's -- choice to adopt or ignore that advice. And there is not a damned thing I could do about it if Ron chose to continue in his destructive ways.

About 15 years ago, I gave up the role of advice-giver and judge of Ron's behavior, which had led to our estrangement. After all, he was 46 years old. I realized that, despite my best intentions, he saw my efforts as an intrusion. I butted out.

I changed my relationship with him, playing a supporting role when the consequences of his actions became dire -- near-homelessness, medical and dental crises, and legal actions. I accepted the reality of a persistently disabled brother. I became Ron's safety net. It is a role I would recommend to others -- and would take on again. It is the only important role to play if you wish to stay involved in your loved one's life.

Deaf to My Advice

ADHD symptoms always stood in the way of Ron's taking my advice. Research suggests that ADDers do not judge themselves as being different in their driving performance than non-ADHD adults, despite their history to the contrary. And ADDers are less likely to use information and skills for self-improvement than someone without the disorder.

Ron knew what a seatbelt is for. He got tickets for not wearing one. Yet his failure to use a seatbelt led to his death. So I ask: Why don't people with ADHD do what they know to be good for them?

I chose to be a safety net, albeit an imperfect one. Would Ron have died earlier had the net not been provided? I would take the same course again if I could, because being estranged from my beloved brother wasn't an option.

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